KMID : 1037220220280040161
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Archives of Aesthetic Plastic Surgery 2022 Volume.28 No. 4 p.161 ~ p.164
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Delivery technique for the pedicled transverse rectus abdominis myocutaneous flap
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Lee Jin-Sun
Kwon Hyeok-Dong Lee Won-Suk Oh Sang-Ha
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Abstract
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The pedicled transverse rectus abdominis myocutaneous (TRAM) flap is often used during breast reconstruction. After completely elevating the flap, a medial tunnel is created to connect the dissection area to the mastectomy defect. This tunnel should typically accommodate four of the surgeon¡¯s fingers, although this may vary depending on flap volume. Wider tunneling facilitates flap delivery, but can damage the breast and inframammary fold. Therefore, we introduce a technique to move the flap easily and safely through a small tunnel. During breast reconstruction using a pedicled TRAM flap, a tunnel was made in the mastectomy defect along the meridian of the breast. This tunnel accommodated a width of three of the surgeon¡¯s fingers (6 cm). After completely elevating the flap, it was inserted into a funnel with an inner surface made of polymeric vinyl and a hydrophilic coating. The flap was propelled into the mastectomy defect via the funnel. Our novel technique for pedicled TRAM flap delivery using a funnel was easy and safe, and it is deemed to be suitable for delivering a pedicled TRAM flap.
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KEYWORD
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Breast reconstruction, Rectus abdominis, Myocutaneous flap, Pedicled flap
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